Provider Demographics
NPI:1326079591
Name:UROLOGY ASSOCIATES OF NORTH CENTRAL FLORIDA
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES OF NORTH CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:RIFKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-333-5400
Mailing Address - Street 1:1179 NW 64TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4218
Mailing Address - Country:US
Mailing Address - Phone:352-333-5400
Mailing Address - Fax:352-333-5404
Practice Address - Street 1:1179 NW 64TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4218
Practice Address - Country:US
Practice Address - Phone:352-333-5400
Practice Address - Fax:352-333-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0062982208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45865OtherBCBS GP#
FL45865Medicare ID - Type UnspecifiedMC GP #